{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T17:51:19Z","timestamp":1760205079970,"version":"3.41.2"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,7,5]],"date-time":"2020-07-05T00:00:00Z","timestamp":1593907200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Science and Technology Major Project","award":["2018ZX10302204-002"],"award-info":[{"award-number":["2018ZX10302204-002"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81700531"],"award-info":[{"award-number":["81700531"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002402","name":"Sun Yat-sen University","doi-asserted-by":"publisher","award":["2016009"],"award-info":[{"award-number":["2016009"]}],"id":[{"id":"10.13039\/501100002402","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010449","name":"Ministry of Education","doi-asserted-by":"publisher","award":["2020KFKT05"],"award-info":[{"award-number":["2020KFKT05"]}],"id":[{"id":"10.13039\/100010449","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The outbreak of coronavirus disease 2019 (COVID-19) has aroused global public health concerns. Multiple clinical features relating to host profile but not for virus have been identified as the risk factors for illness severity and\/or the outcomes in COVID-19.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The clinical features obtained from a cohort of 195 laboratory-confirmed, nasopharynx-sampled patients with COVID-19 in Guangdong, China from January 13 to February 29, 2020 were enrolled to this study. The differences in clinical features among 4 groups (mild, moderate, severe, and critical) and between 2 groups (severe vs nonsevere) were compared using one-way analysis of variance and Student\u2019s t test, respectively. Principal component analysis and correlation analysis were performed to identify the major factors that account for illness severity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In addition to the previously described clinical illness severity-related factors, including older age, underlying diseases, higher level of C-reactive protein, D-dimer and aspartate aminotransferase, longer fever days and higher maximum body temperature, larger number of white blood cells and neutrophils but relative less lymphocytes, and higher ratio of neutrophil to lymphocytes, we found that the initial viral load is an independent factor that accounts for illness severity in COVID-19 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The initial viral load of severe acute respiratory syndrome coronavirus 2 is a novel virological predictor for illness severity of COVID-19.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaa282","type":"journal-article","created":{"date-parts":[[2020,7,5]],"date-time":"2020-07-05T01:34:05Z","timestamp":1593912845000},"source":"Crossref","is-referenced-by-count":13,"title":["Upper Respiratory Tract Viral Ribonucleic Acid Load at Hospital Admission Is Associated With Coronavirus Disease 2019 Disease Severity"],"prefix":"10.1093","volume":"7","author":[{"given":"Xiaoyan","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusheng","family":"Jie","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"},{"name":"Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Meizhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinong","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, the First People\u2019s Hospital of Foshan, GuangDong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Chen","sequence":"additional","affiliation":[{"name":"Syno Minicircle Biotechnology Co. Ltd., Shenzhen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinhua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiliang","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ganwen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Meizhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"},{"name":"Guangzhou Hoffmann Institute of Immunology, College of Basic Sciences, Guangzhou Medical University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yubao","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bingliang","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutian","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengjuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Guangzhou Eighth People\u2019s Hospital, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,7,5]]},"reference":[{"key":"2020073010170672000_CIT0001","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A novel coronavirus from patients with pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N Engl J Med"},{"key":"2020073010170672000_CIT0002","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical characteristics of coronavirus disease","volume":"382","author":"Guan","year":"2020","journal-title":"N Engl J Med"},{"key":"2020073010170672000_CIT0003","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA"},{"key":"2020073010170672000_CIT0004","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S2213-2600(20)30079-5","article-title":"Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study","volume":"8","author":"Yang","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2020073010170672000_CIT0005","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0140-6736(20)30211-7","article-title":"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study","volume":"395","author":"Chen","year":"2020","journal-title":"Lancet"},{"key":"2020073010170672000_CIT0006","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1056\/NEJMp2000929","article-title":"A novel coronavirus emerging in China\u2013key questions for impact assessment","volume":"382","author":"Munster","year":"2020","journal-title":"N Engl J Med"},{"key":"2020073010170672000_CIT0007","article-title":"The role of neutrophil to lymphocyte count ratio in the differential diagnosis of pulmonary tuberculosis and bacterial community-acquired pneumonia: a cross-sectional study at Ayder and Mekelle hospitals, Ethiopia","volume":"65","author":"Berhane","year":"2019","journal-title":"Clin"},{"key":"2020073010170672000_CIT0008","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1001\/jama.286.14.1754","article-title":"Serial evaluation of the SOFA score to predict outcome in critically ill patients","volume":"286","author":"Ferreira","year":"2001","journal-title":"JAMA"},{"key":"2020073010170672000_CIT0009","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1016\/S0140-6736(03)13412-5","article-title":"Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study","volume":"361","author":"Peiris","year":"2003","journal-title":"Lancet"},{"key":"2020073010170672000_CIT0010","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1503\/cmaj.1040398","article-title":"Initial viral load and the outcomes of SARS","volume":"171","author":"Chu","year":"2004","journal-title":"CMAJ"},{"key":"2020073010170672000_CIT0011","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.3201\/eid1112.040949","article-title":"Viral load distribution in SARS outbreak","volume":"11","author":"Chu","year":"2005","journal-title":"Emerg Infect Dis"},{"key":"2020073010170672000_CIT0012","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1038\/nrmicro.2016.81","article-title":"SARS and MERS: recent insights into emerging coronaviruses","volume":"14","author":"de Wit","year":"2016","journal-title":"Nat Rev Microbiol"},{"key":"2020073010170672000_CIT0013","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1056\/NEJMc1511695","article-title":"Viral load kinetics of MERS Coronavirus infection","volume":"375","author":"Oh","year":"2016","journal-title":"N Engl J Med"},{"key":"2020073010170672000_CIT0014","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1002\/jmv.25685","article-title":"Coronavirus infections and immune responses","volume":"92","author":"Li","year":"2020","journal-title":"J Med Virol"},{"key":"2020073010170672000_CIT0015","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.chom.2016.01.007","article-title":"Dysregulated type I interferon and inflammatory monocyte-macrophage responses cause lethal pneumonia in SARS-CoV-infected mice","volume":"19","author":"Channappanavar","year":"2016","journal-title":"Cell Host Microbe"},{"key":"2020073010170672000_CIT0016","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1093\/infdis\/jiy115","article-title":"Factors associated with prolonged viral shedding in patients with avian influenza A(H7N9) virus infection","volume":"217","author":"Wang","year":"2018","journal-title":"J Infect Dis"},{"key":"2020073010170672000_CIT0017","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofaa282\/33464595\/ofaa282.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/7\/7\/ofaa282\/33550363\/ofaa282.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/7\/7\/ofaa282\/33550363\/ofaa282.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T17:34:04Z","timestamp":1596130444000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofaa282\/5867518"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,1]]},"references-count":17,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofaa282","relation":{},"ISSN":["2328-8957"],"issn-type":[{"type":"electronic","value":"2328-8957"}],"subject":[],"published-other":{"date-parts":[[2020,7]]},"published":{"date-parts":[[2020,7,1]]},"article-number":"ofaa282"}}